Beds in €1bn HSE capital plan below level needed to cater for growing population

More than 260 hospital beds are to be provided this year as part of the Health Service Executive’s (HSE) €1 billion plan to upgrade the infrastructure of the health service.

However, many of the 261 beds to be provided under the HSE capital plan for 2023 are refurbishments of existing stock rather than additions. The refurbishment of 37 beds in a ward of the Coombe Hospital this year will yield just one additional bed, for example.

Last month, a report estimated the Irish health service needed an additional 1,000 beds immediately, and 300 additional beds a year to keep up with population pressures.

Additional capacity will have to come from new building because there is no space to fit more beds into existing hospitals, the Oireachtas health committee was told by officials last week.

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Minister for Health Stephen Donnelly is seeking to fast-track the provision of hundreds of additional beds in modular units, and is hoping the recent relaxation of capital spending rules will make this easier.

“Work is being undertaken in 2023 to explore opportunities to provide additional acute hospital inpatient accommodation in line with ministerial priorities,” the capital plan notes.

Continuing work on the new national children’s hospital is the largest single investment in the capital plan, at €324 million. Any fluctuation in this spend risks impacting the remainder of the capital programme, the HSE warns.

The plan envisages spending of €967 million on healthcare infrastructure, equipment and furnishing in 2023, with a further €50 million for Covid-related capital infrastructure. This is roughly similar to the amounts available last year. Some €615 million of this money is need for existing contractual commitments, leaving a remainder for new projects of €412 million.

It provides for spending of €14.5 million on replacement ambulances, €65 million on equipment replacement across the health service and €20 million on climate action measures.

Despite a stated commitment to reducing carbon emissions in health, climate action is accorded the lowest priority for the selection of projects, according to the report – a weighting of 0.2 against 1.0 applied for patient safety and clinical risk, and for regulatory requirement and compliance.

The target of achieving net carbon emissions of zero by 2050 will require a “substantial uplift” in capital funding in future years, the plan warns.

The HSE also warns of a number of challenges, concerns and risks that could affect delivery of the plan this year, including spending on the children’s hospital, construction inflation, the increasing costs of new building standards and regulations, and labour issues.

Under the plan, new primary care centres will be completed this year in Monaghan town, Clones, Glasthule/Sallynoggin, Laytown/Bettystown, Castlebellingham, Kilbarrack, Portumna, Roscrea and Clondalkin.

Enhanced community care hubs will be completed in Galway city, Ballincollig, Clonskeagh and Cherry Orchard.

The plan commits only to “progressing the design and development” of three planned elective hospitals in Cork, Dublin and Galway, which have been delayed for years by planning and other issues.